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With help from Kyle Cheney, Jennifer Haberkorn, Joanne Kenen, David Nather, Brett Norman and Kathryn Smith

HHS TO STATES: OK, HAVE SOME MORE TIME — Underpressure from Republican governors to push back the deadline for states to declare whether they’ll run their own exchange, the Obama administration yesterday announced they’d give states another month to submit their letters of intent. The delay came literally one day before the administration’s original deadline, and it came as all but about 10 states had formally declared their intentions. The POLITICO story: http://politi.co/ZTrKW9

REPUBLICAN GOVERNORS: THANKS! — The Republican Governors Association, which had asked on Wednesday for a delay, was grateful for the news. “We appreciate the administration’s acknowledgement that not enough information has been provided to the governors and hope this is a signal that the White House intends to engage directly with the governors on the substantial policy issues that remain unresolved and are open to real reform,” said RGA spokesman Mike Schrimpf.

DOES THE DELAY HELP HHS? – So are a bunch of Obamacare-skeptical states over the next month suddenly going to have a change of heart? Former HHS exchange director Joel Ario said he’s “not surprised” that HHS pushed back the deadline, considering the administration’s efforts to show flexibility and encourage states to build their own exchanges. “There’s potential that some of the states that have made statements may now rethink that for December,” said Ario, now a consultant for Manatt. “A number of governors have been asking for more time so HHS is being flexible, but doubt it changed very much,” said Ray Scheppach, former executive director of the National Governors Association.

Happy Friday and welcome to PULSE, where we can’t wait to play the exchange speculation game again the week of Dec. 14. That’s a Friday, by the way. Of course it is.

“Twenty, twenty, twenty four hours to PULSE, I wanna be sedated”

TODAY ON POLITICO PRO:

--TREND WASN’T LOOKING GOOD FOR STATE EXCHANGES — HHShas said all along that it wants states to do their own exchanges, but as the state announcements came rolling in this week, it became clear that those that were hesitant before weren’t suddenly going to take a giant leap of faith. And it’s not clear that the deadline delay is going to help much. The POLITICO Pro story: http://politico.pro/Ut8KZc

--OHIO SHOWS PLANNED PARENTHOOD DEFUNDING FIGHT NOT OVER — The election is over, but the political battles aren’t done for Planned Parenthood.A bill that would essentially defund Planned Parenthood in Ohio was approved in the Ohio House Health and Aging Committee on Wednesday, and it is now on its way to the full state House — and Republican majorities in both the state House and Senate look likely to approve the bill. http://politico.pro/StULT3

TELL US HOW YOU REALLY FEEL, IOWA – Iowa Gov. Terry Branstad’s spokesman wasn’t all that excited about HHS pushing back the exchange deadline. “This is more of the same from HHS and their disorganized bureaucracy that’s trying to pass itself off as a health care program,” Tim Albrecht said in a phone interview. “This just proves the disorganization and bureaucratic nightmare that is Obamacare. We were ready to send our letter tomorrow. We are going to send our letter tomorrow despite another arbitrary deadline that wasn’t even set forth within the law.”

ARIZONA DELAYING DECISION – A Republican state that has been pretty advanced on exchange planning, Arizona’s going to wait until next month to make a decision. “Gov. [Jan] Brewer wants to make sure she has as much information as possible before making a decision of this critical importance,” Brewer spokesman Matthew Benson told The Arizona Republic: http://bit.ly/S1jRds

NEBRASKA GOES FEDERAL – Even after the insurance department had been diligently planning to run its own exchange, Gov. Dave Heineman said yesterday that his state would opt for a federal exchange and try to make sure it runs smoothly. “A state exchange is nothing more than a state administering the Affordable Care Act with all the important and critical decisions made by the federal government,” he said in a press conference. He also rejected the partnership model, essentially calling it a false choice that would still give the feds total control.

OH, YOU DON’T SAY? – Before the Friday deadline was pushed back, some states really opposed to Obamacare used the deadline to once again affirm that, no, they’re not going to help implement that terrible, terrible law. Among those states: Alaska, Louisiana, South Carolina and Texas. A sampling: “The full extent of damage the PPACA causes to small businesses, the nation’s economy, and the American health care system will only be revealed with time,” Louisiana health Secretary Bruce Greenstein wrote to HHS. “The State of Louisiana has no interest in being a party to this failure by implementing a state based exchange.” His letter: http://1.usa.gov/TLNdfT.

TENNESSEE SURPRISE? — Will Tennessee Gov. Bill Haslam be one of a few Republicans to pull the trigger on a state-based exchange? Senate Speaker Ron Ramsey, a Republican, certainly seems to think so. But Ramsey said the move would really just allow Tennessee more time to decide. “All that really does is kick the can down the road — as the federal government has done with this — and leave our options open," he told The Associated Press. Of course, that was all before HHS pushed back the deadline. The story: http://bit.ly/PX8ogL

** A message from the National Community Pharmacists Association: When manufactured drugs aren’t an option, independent community pharmacists provide traditional pharmacy compounding to prepare customized medications for patients in accordance with a doctor’s prescription based on the patient’s individual needs. Learn more at www.ncpanet.org **

BOEHNER: OBAMACARE OVERSIGHT IS MORE IMPORTANT NOW – No, it’s not a coincidence that more Obamacare subpoenas are flying now. House Speaker John Boehner is talking up the importance of congressional oversight now that the elections didn’t give Republicans the power to repeal the law. In a post on Boehner’s blog Thursday, his staff wrote: “As the president’s health care law continues making it harder for small businesses to hire, Speaker Boehner this week is urging colleagues to recognize the critical role congressional oversight will play in repealing Obamacare going forward.” The post quoted from a letter Boehner has sent to House Republicans, which noted that “there are three possible routes to repeal of Obamacare: the courts, the presidential election and our constitutional responsibility for oversight. With two of them having come up short, the third and final of these becomes more important than ever.” The blog post: http://1.usa.gov/SPPwgZ

HOSPITALS: SERIOUSLY, STOP THE SEQUESTER – The Federation of American Hospitals sent its pitch to members of Congress yesterday: Hospitals aren’t the ones who are driving up health care costs, so repeal or delay the sequester. “Sustainable changes to health care spending are best achieved by thoughtful policies that address the full range of root causes that drive hospital costs,” the group wrote. “We cannot continue to absorb additional cuts and still provide the care seniors expect and the jobs communities need.” The letter: http://bit.ly/T5auvE

WHITE HOUSE HEALTH AIDE MOVING ON – Today is the last day at the White House for Liz Fowler, who has been working on health policy at the National Economic Council. A longtime aide to Senate Finance Chairman Max Baucus — she played a key role in shaping the health law in 2009 — she’s also worked on implementation at HHS. No word yet on what she’s doing next.

SEN. KENT CONRAD: RAISING MEDICARE AGE IS OK — Theretiring Budget Committee chairman gives new meaning to the term “outgoing.” Conrad tells The Washington Post’s Suzy Khimm that he thinks it’s OK to raise the Medicare eligibility age now that the nation will have health care exchanges. “As part of an overall package, that’s balanced and fair. Given that we now have exchanges to purchase insurance because of the president’s health care reform law, it makes it much more acceptable, much more reasonable, over a long period of time to gradually increase the age given that people are living so much longer,” he said. The Washington Post blog item: http://wapo.st/RFipxx

GAO: MEDICARE AND MEDICAID FRAUD PREVENTION SYSTEM LACKING – The watchdog office made the assessment in a report issued yesterday, determining that while CMS says it intends to retool its system, many of the details remain murky. In particular, CMS has touted its move to a fraud detection system that prevents funds for suspect claims from going out the door, rather than forcing investigators to chase fraudulent claims after the money has been spent. But GAO said this fraud prevention method hasn’t been fully integrated with CMS’s payment processing system. “CMS has not yet defined or measured quantifiable benefits, or established appropriate performance goals,” according to the report. “GAO recommends that CMS develop schedules for completing integration with existing systems, define and report to Congress quantifiable benefits and measurable performance targets and milestones, and conduct a post-implementation review of FPS.” The report: http://1.usa.gov/UH3Td7

GAO: MEDICAID ACCESS SIMILAR TO PRIVATE COVERAGE – Another GAO report released yesterday found that in 2008 and 2009, less than 4 percent of Medicaid beneficiaries with full-year coverage said they had trouble getting care — about similar to private insurance rates. The news wasn’t all that good, though: Medicaid beneficiaries had a tougher time getting dental care, and the report found those with less than a full year of Medicaid coverage were almost twice as likely to say they had a tough time obtaining care compared to beneficiaries with full-year coverage. The report: http://1.usa.gov/UIkKfr

ET TU, DENNY’S? – Per the Huffington Post: A franchisor of the popular restaurant announced plans to add an “Obamacare surcharge” at the 40 Denny’s locations he operates, as well as at Hurricane Grill & Wings. John Metz, a restaurant franchisor who operates 48 locations of Hurricane Grill & Wings, several dozen Denny’s locations and a few Dairy Queens, told The Huffington Post that he’d join the growing list of restaurateurs piling purported Obamacare costs onto their customers and staff. “If I leave the prices the same, but say on the menu that there is a 5 percent surcharge for Obamacare, customers have two choices. They can either pay it and tip 15 or 20 percent, or if they really feel so inclined, they can reduce the amount of tip they give to the server, who is the primary beneficiary of Obamacare,” Metz told The Huffington Post. The story: http://politi.co/WadpAL

AN EXCITING NAIC CALL! – We mean it! The NAIC’s new committee devoted to federal exchange issues is scheduled to host its first open call at 1 p.m. As a refresher, Pro’s August story on the group: http://politico.pro/OMoA1j

NEXT GOP COMPLAINT ABOUT GOOFY RESEARCH FUNDING? — NIH sent out a release yesterday titled: “This is your brain on freestyle rap.” It was touting a recent brain imaging study by the National Institute on Deafness and Other Communication Disorders that examined the patterns of brain activity in rappers "spontaneously improvising lyrics in real time." Not worthy of tax dollars, you say? It won't put Alzheimer’s out of sight, or cure deafness overnight, but there are other things that it might ... never mind. The researchers propose a new neural network that could provide "insights into the initial, improvisatory phase of the creative process." The release: http://1.usa.gov/Xe8nJB

President Barack Obama’s reelection, together with the Supreme Court ruling upholding the health care law, is removing the uncertainties about investing in health care mutual funds, The Wall Street Journal reports. http://on.wsj.com/ZEHr47

** A message from the National Community Pharmacists Association: Traditional compounding pharmacy services help avoid allergic reactions to mass-produced drugs; get children the relief their pediatrician prescribed; and bridge the gap during drug shortages. These community pharmacists satisfy unique, individual health needs on a patient-by-patient basis. They should not be confused with rogue drug manufacturers, such as the company at the center of the tragic meningitis outbreak. Pharmacists are working constructively with Congress and others to preserve patient access to traditional compounding services, while thwarting any illegitimate manufacturers. Learn more at www.ncpanet.org. **